PITFALL - well appearing hypotensives - be vigilant - people can present with hypotension with absence of hypoperfusion

CODE SEPSIS CRITERIA - SBP< 90 after 2 liters or severe sepsis with lactate >4 with presumed infection & need for ICU care. Goal of calling out code to antibiotics is < 60 min; goal to time to the ICU is 90 minutes

20% of patients in shock may not manifest elevated lactate

2 studies - sepsis with intermediate lactate range (2-4) -- despite care 1/3 of these patients are admitted to the ICU within 3 days